Project Summary/Abstract: This application requests funding for a project to improve maternal fetal healthcare using retinal pictures called optical coherence tomography angiography. Pregnancy is a complex process that can lead to complications such as preterm birth and preeclampsia. Preterm birth occurs in about 1 out of 10 pregnancies and is increasing due to increasing rates of in vitro fertilization, advanced maternal age, and multiple gestations. Preeclampsia, occurring in about 5-8% of all pregnancies, is an important cause of maternal morbidity and mortality throughout the world. This study will image pregnant women with optical coherence tomography angiography throughout pregnancy and then follow them until after the completion of pregnancy. The study hypothesizes that there will be early findings on retinal imaging that will be able to predict late-term pregnancy complications such as preterm birth and preeclampsia. We will maximize recruitment and retention by utilizing a large high-volume clinic in an academic center and placing a camera on site. Through the completion of this research, we hope to develop a way to better monitor high risk pregnancies and enable the study of early interventions.